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Inserting I.V. lines in patients requiring frequent I.V. insertions
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- Allow the patient to assist in locating a vein; he may know his veins better than anyone.
- Consider using a warm pack or transilluminator to help locate veins.
- Avoid collateral veins, which may be present but aren't appropriate for venipuncture.
- Consider using infrequently used veins, such as the basilic vein on the back of the arm or cephalic vein on the upper arm.
- Use a small gauge to avoid trauma; 22G or 24G should be adequate.
- Pull the skin taut to avoid the skin bunching up on the device.
- Use the most experienced staff members to place I.V. line in these patients.
- Secure the catheter well to avoid repeated venipuncture.
- Draw blood for laboratory tests at the same time as the I.V. line is being inserted to prevent multiple venipunctures.
- Consider alternative access device, such as a midline catheter, peripherally inserted central catheter, tunneled catheter, or port, if frequent access is required or if the patient has veins that are difficult to cannulate.
- Consider leaving the catheter in place longer. Observe closely, and follow institutional guidelines about extending catheter dwelling time.
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